Howard Smith

On January 21, I was sent to Haiti by the American Red Cross (ARC) on a special assignment. Having 17 years of experience as a Disaster Mental Health Volunteer for the ARC I have been deployed to over 25 national disaster relief operations and worked extensively with my local ARC Chapters so I know a bit about disaster relief operations and the mental health impact a disaster has on individuals. However, this was the first time I had been deployed by the ARC International Services Department to a disaster where the relief operation was coordinated by the International Red Cross/Red Crescent organization. There was another mental health worker, a sheltering expert (an engineer) volunteer in our party, and a logistics and two other staffers who were consultants to help manage the financial end of reestablishing the operation of the American Delegation Office that is a permanent office in Port-au-Prince.

We were flown into Santo Domingo, Dominican Republic, since the airport at Port-au-Prince, Haiti, had sustained some damage by the earthquake which occurred on January 12th and was only allowing planes carrying supplies to land there. We were lodged there overnight and then had a 234 mile, 12 hour, bus ride to Port-au-Prince the next day in convoy fashion along with other International Committee of the Red Cross (ICRC) responders from other nations. The bus trip was an education in and of itself. Once we left the four-lane, divided highway, about 20 miles outside of Santo Domingo, every 8 – 10 miles there were speed bumps across the highway and in many instances, vendors, had set up stands along the side of the road selling fresh fruit and local crafts. We had heard that there had been significant delays at the border between Haiti and the Dominican Republic; however it took us only about an hour to be cleared and allowed to enter Haiti.

Once we arrived in Port-au-Prince, due to the damage and debris that literally blanketed the city of 1.75 million residents, it took us over 3 hours to get to the Base Camp that was being set up by the ICRC. In an International Response to a disaster, nations work closely together so that every nation does not have to deliver a full component of services. So in addition to the American Delegation office staff (n = 10) who had been there before, during and after, the earthquake, there were 12 – 15 First Responders from the ARC who were working at Base Camp where supplies were being delivered and dispersed. At the Base Camp, everyone was housed in tents and it became a bit of an International Village with the responders from each respective nation having their tents clustered together in the compound. Those individuals stationed at the Base Camp worked long and hard hours, ate, and slept inside the compound. The extreme heat and humidity added to the discomfort. What few amenities that existed were welcomed. Many different languages were being spoken with efforts to cooperate, collaborate, and communicate with responders from other nations. Each nation had its specific tasks to perform but it was also vitally important that they all work together.

One of the ARC Delegation staff members had not been heard from since the earthquake and was presumed dead. A few more had to move out of their damaged apartments. The ARC staff at Base Camp had been working 18 – 20 hour days in an attempt to get set up for and respond to the huge response that was required in the immediate aftermath. Fatigue, if not exhaustion, was beginning to show. The added stressors of the many languages, the intense heat, the constant drone of the gas and diesel engines used to generate electricity, and the lack of adequate cell phone towers all were beginning to take a toll.

The special assignment for me and the other disaster mental health person was to provide mental health support to the other ARC people and their respective staff members and to assess the need for an on-going mental health presence for these responders. That is very different from a domestic disaster in which mental health responders provide services to the people most directly impacted by the disaster as the primary focus, and to the other responders as a secondary mission. In this case, the language used by the Haitians was primarily Creole and Haitian culture was less open to mental health assistance than most others.

As indicated earlier, many of the streets were still blocked by the buildings that had come cascading down during the earthquake. The concrete blocks strewn out in many areas made the streets impassable. Initially, bulldozers simply drove down the streets pushing the rubble aside so emergency vehicles, cars, and trucks could move about. Not surprisingly, many of the local vehicles had flat tires from driving in the rubble and several cars were literally buried under the concrete that had fallen on them. The difficulty in getting from one place to another was exacerbated by the foot traffic walking in the narrow streets.

Amidst all of this chaos, grief, confusion, and difficulty, I found the Haitian people to be very gracious and courteous. They went to great lengths to groom themselves and wear clean clothes when going out and about. At the first aid station that was set up in the compound of the ARC Delegation building that had suffered adequate damage to be declared unsafe itself, people would walk great distances to get the dressing on their wounds changed. They would often stand for hours in line waiting to be helped, in spite of the heat and humidity. If someone came along who had worse wounds than theirs, they would encourage them to go to the front of the line. Amputees were often physically carried in for a change of dressing on their wounds. During the week that I was there I saw only one set of crutches and not a single wheel chair. There were many post-disaster foot wounds where people had stepped on sharp objects as many had either no shoes or merely wore flip-flops.

There were tent cities or shacks strewn all over. The first day we were there a couple of staff members of the ARC Delegation asked if we would like to go for a walk. In this one area close to where the Delegation building had stood, there were over 6,000 individuals living in rows and rows of shacks which they had built out of corrugated tin and scrap lumber they had scavenged from the fallen buildings. A family of 6 would be living in a 10 foot by 10 foot area. They had lost their household goods such as pots, pans, and other necessary utensils but strangely enough, they had obtained food that had been brought down from small mountain farms. There were charcoal grills that had been rigged up to cook stew or broth. Fresh fruit was present and very popular.

Many of the children were finding ways to entertain themselves by making kites from plastic shopping bags and twigs, or playing with some make-shift objects. When ICRC distributed goods, again, the people were generally polite with one another. One truck brought a load of tarps and blankets. These were being distributed as the rainy season was about to begin and the shacks they had constructed were not weather proof. Other things distributed were the household items mentioned above and water.

Overall, the responders were coping very well with the stressors that were ever-present. It enhanced my regard for the volunteers who respond to these hardship disasters. Toward the end of the week, there were a few of those first responders who were getting ready to return home. While going home is part of the experience, in many ways it is the toughest part because they see the need is so great and the job not yet done. And on the other hand there is always the excitement of returning home to family and friends, and a regular job for most.

I left Haiti with some of the same mixed emotions. I wanted to stay and continue to help in whatever way possible at the same time, the magnitude of this disaster for a country that had little to begin with I knew that I was incapable of making a significant difference in their lives. It is a very humbling experience.

My “take-away” message from the experience is this: We, who by accident of birth were, so fortunate to live in this country, to have the benefits of comfort at the level we have them, often times act as if we deserve this good life. After being in Haiti, where the population is so dense and abject poverty reigns supreme, I sincerely hope that I never become so calloused that I either come to think that I deserve what I have in life, or ever become so comfortable that I would not want to do what I can to help those whose accident of birth gave them so little. Even for those of us who cannot “go” to offer assistance, there are many ways we can help through contributing financially or of our time. To be sure, there are areas we can help individuals who are less fortunate right here in our own area. We can read to children, visit the elderly, assist someone who is disabled in some way, or find an agency or an entity that offers assistance and make your contributions through them.