Visiting Leogane Haiti – Mind-Body Skills at Cardinal Leger Hospital
We spend the morning at the Cardinal Leger Hospital, destroyed in the earthquake and quickly rebuilt. Haiti’s lepers come here, older people without legs , or with fingers and toes amputated by the disease; brothers 8 and 12 years old whose noses have collapsed and whose faces and hands already bear the scars of the condition.
The kindly and concerned Sisters and lay nurses who are in charge have been overwhelmed by the suffering around them—staff, friends and family killed in the earthquake, as well as by the weight of sadness their patients bring. Out in the country, living with people whose illness has wasted them, meeting acute care needs, they are clearly stretched thin.
Little by little, they brighten during our workshop, appreciating the relaxation of Soft Belly, laughing with the shaking and dancing—“The first time laughing since last January 12th,” notes one sister.
Here’s a quick video we took of participants dancing at a Port-au-Prince workshop—
Sharing their drawings, One sister notes how rigid her body is in the drawing of her “biggest problem”, and how the flower that she draws in the third picture (“the solution to the problem”), bending gracefully toward the sun, is a “lesson to remember.” Before we close, JJ teaches us all to stretch in our chairs.
Afterwards, outside, the Sisters show us the bushes blooming red, yellow, white, and orange, and reach up with a net to fetch us mangos for the road. “We will use what you have taught us, ourselves,” says Sister Yolande, the Director, “and we will teach our patients too.”
Haiti Snapshot: A Guest Blog by Mark Silverberg, volunteer photographer
Mark Silverberg is a welcome guest blogger. He is an Ohio businessman who read about our work in Gaza (in the NY Times) and got in touch. “I want to volunteer and help,” he said. “I can take pictures.” He came with us to Haiti–we saw the pictures, felt Mark’s heart, and now he is a dear part of our team. He sent us this account of his time in the tent camps.
Enjoy his story.
Jim
We hiked to three tent camps on the side of a mountain today, Thursday morning. Hot as heck. What I saw cannot be described– 13,000 people live in one camp alone. The pictures and videos only begin to tell the story. We were given a tour through the camps by the residents who are elected to help coordinate running the camps, so a school and homes were opened to us. The camp organizers kept introducing us to people and children with problems and asking us how they can help them. We suggested they apply to take the CMBM training. [Note: if this is your first time to the blog, you can read other posts about CMBM's Haiti trainings to help Haitian caregivers help these kids & families]. The visit was a very humbling experience.
An extraordinary experience on Friday morning. I went to the Champ de Mars tent camp across the street from where the CMBM training program was held at to take printed pictures to the kids and families I photographed during the CMBM training in December 2010. Laurent Sheineder helped me find all of the kids and adults in the pictures. They were very surprised to see their pictures and of course posed for many more! They told Laurent and I that of all of the people who had taken their pictures I am the only one to bring them copies. I think they must feel invisible.
by Mark Silverberg for CMBM
Then at lunchtime the organizers of another nonprofit, Zanmi Lakay (ZM) from Oakland, CA picked me up and we went to Cite Soleil. It’s the worst slum in the poorest city in the hemisphere. And we weren’t in the BAD part of the slum. This was big time scary.
ZM organizes basic needs (food, clothing, shelter, medical care, education) for homeless children in Port au Prince. Before the earthquake they had a home and facilities for many children, but the earthquake destroyed the house so the kids are spread out in three clusters in Cite Soleil and Jacmel. The kids also receive documentary photography cameras and training in their care so they can document their lives, tell their stories and express their hopes and aspirations. There have been 5 gallery shows across the US (SF, NYC, DC, Florida) to raise awareness and funds. The kids’ pictures are sold to benefit the organization that helps care for them.
So I was able to be at the first gallery show in Port au Prince, at a cyber cafe in Cite Soleil today. Forget what you think about a cyber cafe. Small, dark, a few folding chairs – but still a space for their pictures, which were taped to the wall with packaging tape. The original location where the show was to open had too many shootings, so it had to move to this new location.
by Mark Silverberg for CMBM
The kids got to see their pictures on the wall, to hear about the gallery shows in the US and the great reviews they got, received certificates for completion of their photography training–I donated items and foodstuffs from CMBM faculty and staff. They asked me to speak, and I told them about teaching photography to kids their age in a poor inner-city Cleveland neighborhood nearly 40 years ago. I encouraged them to continue using photography to express themselves and to clarify their dream, since their dream will keep them going through hard times. It was a gift to be present for the recognition of their struggles and accomplishments.
After leaving Haiti the memories of those two days kept echoing in my mind. I recalled that when I was leaving the school in the mountainside tent camp on Thursday, one of the kids said repeatedly, “We are waiting for you,”–meaning, “waiting for you to return.” On the following day when I brought the pictures to the kids and families in the Champ de Mars tent camp, their reaction was often puzzlement. I later realized it was because their expectation was for people to not come back, to not remember them or be touched by what they saw; to return to their normal lives, unmoved and unchanged.
I hope I’m not that person.
The Key to Haiti's Happier 2nd Anniversary
Sometimes, on this first anniversary of the earthquake, it feels like very large, steady hands are needed to pull together the two sides of the gaping wound that is Haiti, hands that Michelangelo might fashion for this purpose.
I find myself looking around as we circulate through tent camps with little food and water, no health care or education or employment for the tens of thousands of people I see, for the hundreds of thousands who still live like this all across the region. “How can this be?” I shout – but only inside my head – how can we, Americans, the world community, all of us, let this continue? Our hearts were touched a year ago. Politicians said the right things, famous people answered phones on television and lent their shine to the pleas for help. Billions of dollars were pledged. Where are they? Why is there scant organization, no plan, so little mercy and fellow feeling?
It worries me, as much for ourselves–the privileged, literate, and apparently protected– as for those who live exposed to heat and rain and hurt.
In one of our workshops on January 11, 2011, the day before the anniversary, two men – a priest who tends a devastated parish and an accountant who has left his paying job to bring whatever order he can to two tent camps– share their drawings. (Read more about CMBM’s drawing exercise in this earlier Haiti entry.)
The accountant, a large serious man, sees himself planted in the midst of a quilted crop of families, cooking fires and plastic sheeting; the priest’s drawing of his slim black-clad figure is bright with God’s light refracted through a mirror framed in rainbow colors. The drawings of their “biggest problems” are, with no other guidance, no consultation, virtually identical. One side of the pages shows effort – to salvage and succor, hands reaching out, shovels in the earth – and a row of disconnected figures: “the ones who could help but don’t” “the rich and powerful who do not care.” They are barely sketched, drained of color. On the other side of the page, the people in the camps are suffering, but they do have bodies and expressions.
We need to offer them help, ourselves, in order to be human; and we need this at least as much as they need our help. That is the key to a happier future anniversary.
Trauma Healing for Haitian Nursing Students
A hundred nursing students come to our hotel. More than ninety of their classmates died on January 12th in their school building. The sense of sadness and loss are palpable.
They are quiet, expectant, and perhaps a little puzzled at first. What is this “mind-body medicine” all about? And then, as I begin to talk with them about fight-or-flight and stress, they become animated—calling up the unspeakable terror of the earthquake along with the biological facts and personal experience. I explain that just as trauma can produce the symptoms of ongoing stress: difficulty concentrating, sleeplessness, anger, lethargy, flashbacks of death and destruction. The techniques we are going to teach—slow deep breathing, self-expression and self-discovery in drawings, sharing one’s pain and hopes with others, and moving one’s body—can give relief; restore a sense of calmness, provide perspective, grant them a sense of control, open the door to the possibility of a future.
By the time Amy is explaining imagery and Kathy and Lynda are encouraging them in their drawings, the young women are alive with pleasure and discovery. They share first with each other, and then with the whole group. They show us pictures bisected by the barriers between the living and the dead, whom they miss so much, and third drawings that reveal the possibility of feeling, though bereaved, whole again in nature and with family and friends.
By the time we clear away the chairs and began to shake, the girls are waving their arms and laughing. When Bob Marley’s “Three Little Birds (Every Little Thing’s Gunna Be Alright)” comes on, they sing with him, and us. Some of us are still laughing, others crying in release, with gratitude as well as grief.
Afterwards, the Dean of the Nursing School speaks for a moment. “Words,” she says, herself crying, “cannot express what you have done for us today.”
“And,” I think to myself, “what you are doing and teaching to us.”
Trauma Healing for Haitian Red Cross Staff and Volunteers (Croix Rouge Haitien)
Already at 9am, the air is hot and heavy in the workshop tent. Fifty or sixty people are present, most of them quite young, taking notes, wonderfully attentive and responsive. They are a bit shy at first, but as we all introduce ourselves, they offer stories of trembling bodies, panicked hearts, of sights beyond endurance—watching family members crushed under falling concrete.
We teach them slow breathing to quiet the mind and body and relieve stress. They participate with eagerness and enthusiasm. Afterwards they clamor eager to “partager,” to share: “A feeling of calm for the first time since January 12th;” “a letting go in the shoulders;” “this is the first time also,” one adds, “that we’ve had an opportunity to learn about our own psychology, to share our feelings, to look at what stress causes in the body and to feel relief from it.”
After a mid-morning break, 30 or 40 more people join. “We have spread the word,” one of the young men says with a grin. After we do drawings (of “yourself,” “your greatest problem,” and “the solution to that problem”), the HRC staff and volunteers share them in animated groups of three. “There is hope here,” say several, of their third drawings.
They are filled with sunlight after darkness of the second drawing; with music—drums and guitar—and dance and movement, after “the biggest problem” of buried and walled off emotions, broken bodies and silence: “It gives me direction,” says one young woman, and others agree. Several stand to show their drawings to the whole group; many more want to.
Then we push back the chairs and stand together, shaking our bodies and releasing tension. When the music changes, the young people sing together, clapping their hands. Afterwards, no one seems to want to leave. Little groups form around each of our faculty and staff.
Twenty-five or thirty of the Red Cross volunteers and staff write notes of appreciation. Most are translated from Creole and French by our interpreters, and a couple are in English. Here, in English, are a few:
“Today I have found the means to comfort myself when I have a problem, to change my way of thinking and looking at things in other people and in myself.” Jeanty
“I feel so good. If everywhere they could have someone learn these exercises and teach them in their neighborhood, everything would be okay for everybody, and accept life as it is. Thank you so much to teach us. May God bless you and protect you.” Myrka
Many of the young people say spontaneously that the experience, has, in the words of one, “taught me how to face the dangers that present themselves to me instead of flying from them.” Another adds, “I’m very happy with the information that I learned today. Now I know how to confront my fears. I would like to be a part of another one of your workshops. Thanks a lot. I’ll never forget you. We needed it.”
“I’m Elder,” writes a third, “I’d like to say I’m very happy and I say to you a big thanks to you for that. You’ve made me a messenger to a lot of people in the world. Thank you so much for your encouragement and the hope of living you bring to me. I love you very much.”
Many, many of the HRC volunteers and staff tell us how much they appreciated the copies of the exercises that we gave them, as well as the workshop, and that they plan to share what they have learned with others. But still, “we want to learn more.” A number invite us to come to visit with them, to bring “workshops of healing” to family members and friends in schools, tent camps, and churches in Port-Au-Prince and beyond.
These idealistic, committed, bright young people (some Red Cross staff, most volunteering), are such an important resource for Haiti’s future. They have a tremendous appetite for learning about themselves and the world, and for helping others. I would very much like to do a full professional training for them.
CMBM's Drawing Exercise Resonates in Haiti
We move during the rest of our week in Haiti from one group of health professionals and community leaders to another. It is a slow progress through the traffic jams in Port-Au-Prince’s rubble-narrowed streets, and sometimes even slower over the gorged-out, flooded dirt roads that take us to Bishop Pierre Andre Dumas’ diocese in Anse-a-Veau, three hours outside the city.
We use a variety of techniques in our workshops, including explanation of the fight-or-flight and stress responses, meditations, guided imagery, and shaking and dancing. We also do a drawing exercise that has been enormously helpful to children and adults in war, post-war, and post-disaster situations, in Kosovo, Gaza, Israel, and New Orleans, and with US military. For a while, everyone—bent over paper, crayons in hand—becomes young, earnest, playful, surprised.
The drawings allow people to tap into their intuition and imagination without effort. As a series of pictures unfolds, they find themselves creating images they’d never imagined, sketching solutions to problems that seemed insoluble.
In Haiti, we guide our groups through three drawings. The first picture is of “yourself,” the second, “you and your greatest problem,” and the third calls for “the solution to that problem.” (We modify the exercise when we use it with children: read my post about using the drawing exercise with Haitian children in the General Hospital.) Afterwards, participants share their drawings in groups of two or three, telling what they see in what they’ve created and how it makes them feel. Then they have the opportunity to share with the entire group.
As you will see, the results are often touching, and almost always surprising.
Here are a few examples and snapshots of the workshops in which they are created:
For L’Institut Haïtien pour la Doctrine Sociale Chrétienne (Haitian Institute for the Christian Social Doctrine)
Such wonderful, accomplished people: 100 of them—physicians, architects, lawyers, police officials, business men and women. All, in this time of crisis, are renewing their commitment to the welfare of those who have suffered even more than they have. They tell us about the terrible sadness—their own, and others—and about unaccustomed irritation that surfaces at home and at work, as if, somehow, angry will could restore what has been lost.
An obstetrician/gynecologist, tall, broad-shouldered, powerful and handsome in a bright, tailored shirt, has come “for rest and peace—I have not slept since January 12th.” He says he works “always” to forget the loss of his house, the deaths in his family—his sister, nieces, nephews—as well as to care for his patients. In his second drawing (a picture of his biggest problem), he is inside a tunnel, tiny as an ant, lost, unable to touch the equally tiny figures outside. In the third (a picture of his problem’s solution), the figures are larger, recognizably human. They are dancing together and he is laughing, “for the first time since the quake.”
For Anse-a-Veau diocese—nuns, priest, lay brothers
Out in the countryside a couple days later, we are meeting with priests, nuns, and lay brothers in Bishop Dumas’ diocese. It’s like rural Africa out here: lush, green and very still, faded pastel cottages with tiny yards in which seeds, sown or thrown, produce a few vegetables and fruits. We begin and end our visit with Bishop Dumas’ blessing and simple ceremonial meals: tiny, boned, tender white fish, rice, beans, greens, fresh lemonade and thick coffee.
The religious, in straight-backed chairs, are as still and elegant as the statues in the porticos of Chartres. They are so attentive, so sweet tempered amidst the flood of suffering, homeless, city people that the earthquake has forced back to the countryside. One priest draws a scene of despair—“The Cross of Death—Good Friday without Easter Sunday,”—and then, in his third picture, much to his amazement, produces a sun that covers the page with radiant yellow. “It’s the sun of freedom. Together we can overcome.”
They dance, too—nuns, brothers, and priests together—as freely and as happily as children. Before we finish in mid-afternoon, another, older priest calls the Bishop from the next diocese. It turns out he would like us to come there.
More soon about another workshop, this time with the Haitian Red Cross staff and volunteers . . .
At School in Haiti: Andre's Story
At the end of the third class, a quiet, solemn boy asks if he can speak with me. “What,” he had wondered during class, “about memories of the lost person that come back again and again?”
While Kathy and Lynda teach the fourth class, Laurent, Cassidy and I sit with – I’ll call him “Andre” – in the only quiet, moderately private spot we can find: our vehicle.
Andre says that he has great difficulty falling asleep, and when he finally does, nightmares always come. “I feel so helpless. I cannot talk to anyone.” He grabs his throat with every other sentence. When I mention the gesture, he tells me that his “words are stuck in my throat. And I am afraid to cry. It is not manly.”
Andre tells us that on January 12th, he was supposed to pick up “my cousins who I love very much, at the University.” He called to them that he couldn’t. They stayed late, and died when the building collapsed.
These cousins, “my best friends,” lived with him and were more like sisters—“one light skinned, one dark,” he smiles with the memory. “I feel so guilty. I want to go back to the time and save them, but it is not possible. I have concluded,” he lowers his voice here, “I do not want to be left behind.”
I recognize the self-annihilating weight of this guilt, have seen it burden young and old in Kosovo, Israel, Gaza, have heard how it torments the nights of soldiers and marines returning from Iraq and Afghanistan.
“Would you,” I ask him, “be willing to meet your cousins in your imagination to talk with them and ask for their advice?”
“I have them always in my heart, but when I talk with them, it makes me cry.”
I tell him that he needs to cry—that releasing his emotions will open his throat, that perhaps his cousins have something to say to him that will help him with his guilt. He nods in agreement.
I ask him to close his eyes and breathe deeply with his belly soft, as we did in class. “Imagine that you are in a safe and comfortable place—a place where you feel good.” He does and I ask him to imagine that his cousins are there with him.
“Would you be willing,” I say, “to ask them for their advice?”
He nods his head.
After a while, his face softens and small tears appear at the outer edge of his eyes.
“Did they come?” I ask.
“Yes.”
“What was it like? What did they say?”
“I was so happy to see them. They told me to keep living my life and that I was not responsible for their death.”
“Write it down,” I say to him, after he has opened his eyes “and look at it every day. “Keep living your life. You are not responsible.”
I notice that he is breathing more deeply and no longer clutching at his throat.
Making our way back to the classroom, I feel how urgent it is to train hundreds of people to do this tender, powerful, necessary work.
We’ve just returned from our visit to Haiti today. I look forward to taking a look at what you’ve got to say on this and other posts from Haiti soon.
At School: A Place to Help Haitian Children
The school is the College Canado Haitien, one of the best in Port-Au-Prince, we are told, before the earthquake and afterwards, too. The students, a few weeks after the school has reopened, are sharp in well-pressed maroon and khaki uniforms—the girls’ hair pulled through berets, the boys sideburns neatly trimmed, tout propre, I think.
Instead of the pre-earthquake concrete buildings, there are open sided wood and metal sheds. Sounds flow from one classroom to another, overlapping in a kind of reverberating clamor. Toward the end of one of our classes, when time of dancing is kept by nimble palms on desktops, the whole campus rocks.
Our equipe, our “team,” –the French is beginning to emerge from deep layers of my unconscious—includes six of us: Lee-Ann juggling logistics as before, with Cassidy, my assistant back home, here to help her and me; Amy, the social worker who is our clinical director, will come tomorrow. Today, Lynda and Kathy, psychologist and family physician, are with me. They are CMBM senior faculty who are adventurous enough to come and to commit to coming again and again. They and Amy will teach our Haitian colleagues and provide consulting and supervision as we build our program.
Today we have been invited by Frere Jacques Anthony Germeil, the principal, to College Canado Haitien. We will have an hour in each of four classrooms with eleventh and twelfth graders who have been told they will learn “lessons in dealing with stress.”
I lead the first class and the third, forty twelfth graders in each, sitting shoulder to shoulder at their desks. Lynda and Kathy, experienced with kids, but new to Haiti and to the trauma and loss that overwhelms the population, will lead the second and fourth classes.
We begin our classes lightly—a little goofily—“How do you breathe?”, I ask to general puzzlement, and then talk about babies doing it easily—naturally—their bellies rising and falling, while adults, and even high school students, cramped in chairs and on benches, barely move their chests. Laurent, my interpreter, and I act out the roles of cats in full fight or flight mode—hissing and growling at each other, and then stepping back to breathe easily. Lynda has her all-boys class—a surprise—consider Kobe Bryant, cool and relaxed, imagining his shots, inspiring the boys to imagine theirs swishing the net.
When we turn the topic to relaxation’s antipode, stress, the bravado of a few—“I’m fine, we’re all fine,” claims one boy; “it was simply a natural disaster” intones another—contends with the more complex memories of their classmates.
Soon, in each and every class, there is a rush of sharing of what happened on January 12th, of how surprise and relief yielded to horror. “I thought the shaking would be eternal. Then, it stopped, and I thought, ‘that’s not so bad, I am ok,’ and I laughed, then I saw my sister covered in dust like a ghost, and I was afraid. And then, underneath my neighbor’s house, there were twisted bodies.”
And the stories come—many, we learn, shared for the first time—and the classmates’ losses pile up: a mother gone, an older brother, “my best friend,” “almost my whole family,” We hear of bodies discovered under rubble and strewn on sidewalk, of dogs chewing on corpses.
When we ask if there are questions, a small forest of hands rises: “How do you go to sleep when these memories keep coming in nightmares?” “How can you breathe deeply to relax when the air is so bad?” “How do you deal with family members who now are arguing all the time?” “What do you do with your belief that another earthquake is coming, or as some say, ‘a tsunami’?”
More about the techniques we use to address these questions coming soon . . . .
