As the devastation of the 7.0-magnitude earthquake that hit Haiti on January 12th continues to unfold, public and mental health experts are likely to be at the fore of those monitoring the situation. In addition to the immediate needs of survivor rescue, survivors of earthquakes and other natural disasters are at risk of malnutrition, parasite infection, and post-traumatic stress disorder and depression. While it is important to ensure that emergency medical care is delivered to those in need, it is also critical that a plan be put in place to ensure that infection and stress disorders are recognized and treated efficiently.
Time magazine reports that before the earthquake, Haiti was one of the poorest countries in the world. No Haitian city had a public sewage system, less than half of the population had access to drinking-water services, and malnutrition and disease affected a large portion of the population. According to CNN, the Red Cross has estimated three million people – one-third of the total population of Haiti – are affected by the earthquake. Many of those not among the reported 200,000 who lost their lives were seriously injured and will likely require amputations or other surgeries. As time passes, these acute health problems will be replaced by chronic heath conditions that may worsen quickly if individuals are not receiving treatment.
According to Columbia University public health expert, Josh Ruxin “The number one risk [following a natural disaster] is always bacterial infections where they have open wounds.” Without antibiotics and proper treatment, wounds can become infected and put individual’s health at risk. Though some were not physically harmed by the earthquake, reports indicate that 40,000 were left homeless and forced to “cluster together in public places without food, clean water or sanitation.” For individuals displaced by earthquakes or other catastrophic situations, the risk of contracting diseases or developing parasitic infections is increased. Water supplies can become contaminated quickly in refugee camps or settings with damaged potable water distribution systems, leading to a rapid spread of water-borne illnesses such as cholera and dysentery as well as diarrhea, malaria, and measles.
Some experts note that not all of the harm of this disaster will be physical. Dr. Daniella David, professor of clinical psychiatry at the University of Miami’s Miller School of Medicine, explains that “Once the initial resources are in…is when the psychological aftereffects are going to hit people.” Further, she explains, there is a normal and immediate stress response that accompanies a devastating effect that causes damage to homes and loss of friends and family members. According to Sandro Galea, chair of the Department of Epidemiology and Columbia University’s Mailman School of Public Health in New York City, acute stress, post-traumatic stress, and depression will likely be seen in Haiti at three to four times higher than baseline in the coming months. Symptoms of post-traumatic stress disorder (PTSD), including depression, anxiety, emotional numbing, and sleep disorders, are usually seen within three months of the incident, according to the Canadian Mental Health Association. According to experts, assistance for potential sufferers of PTSD – often called “psychological first aid” – includes making individuals aware of what signs and symptoms to watch for, and letting them know that their feelings are normal and that help is available. While reporting of PTSD and other psychological disturbances is frequently a concern due to the social stigma attached to mental illness, Haitian-born psychologist Marie Guerda Nicolas of the University of Miami indicates that Haitians tend to be expressive of their grief and psychological distress. Further, members of rescue teams from other nations at as great a risk, if not an increased risk, of developing PTSD or psychological trauma.
Though a global humanitarian response is currently underway, aid organizations face a daunting task as they attempt to coordinate vast amounts of aid relief and get it to individuals who require it urgently. It remains to be seen exactly how many were affected by the earthquake and if assistance can be delivered effectively to them, but the impact of the earthquake on Haiti and its people is likely to continue after the initial wounds have healed.
Specialty physicians who wish to offer teleconsultation support to disaster-relief workers in Haiti, health professionals who wish to provide volunteer support on the ground in Haiti, and U.S. healthcare institutions that are willing to provide services to victims of the earthquake who are airlifted to this country for urgent medical or rehabilitation care can register through iCons in Medicine