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 . . . .
Barth Green stands easily in the middle of the dusty yard in front of two small administrative tents, just inside the gate of the University of Miami’s Global Institute field hospital at the Port-au-Prince airport. His blue shirt is clean and crisp, cream colored pants still pressed, his grey hair combed straight back. There is a storm of activity around him, squalls of need coming from every corner of the encampment.
Men and women in scrubs, some with IV bottles in hand, rush up to ask questions. Military commanders and visiting dignitaries stand in a small circle around him. Barth Green responds thoughtfully, unhurriedly, sometimes with humor, to each person in turn. He is the director of the hospital and of the entire facility – the huge tent which contains the operating room and the acute wards for children which are attached to it, the other large one for adults, the small tents for convalescence and isolation, the tent-barracks where hundreds of volunteers lie on cots just like the ones the patients have.
Barth Green is chairman of the department of neurosurgery at the University of Miami Medical School. Since 1994 he and his colleague, family physician Michael Fournier, have been leading Project Medishare in Haiti, helping (along with the US based Partners in Health and the Haitian Ministry) to bring good primary care to the Haitian countryside. When the earthquake hit on January 12, he and his colleagues moved quickly; volunteers arrived. Some were skilled as physicians, surgeons, OR techs and nurses; others were simply, surprisingly even to them. moved to help: “at least I’m another pair of hands,” more than one says. Since then the “barely controlled chaos” as several doctors describe it, has been providing treatment for thousands, saving lives. And a surprising life enhancing life changing experience of selfless service for many who have come to provide that treatment and save those lives. “For me,” a tired looking fifty-ish U of M ER doc confides, “this has been the most important experience of my professional life. Maybe,” he adds after a moment, ” of my whole life.”
In Barth Green the surgeon’s calm amidst crisis and attention to present, necessary detail is coupled with an understanding of long term needs. He knows that the deepest despair and the greatest distress may arise only when the immediate crisis is over; and he recognizes the importance of CMBM’s commitment to helping caregivers deal with their own stress and trauma and to teaching them to help the Haitian people to help themselves. He reads over our annual report and our tentative Haitian work plan, and shares them with Carl Eisdorfer, the former chair of Miami’s department of psychiatry, and present director of its program of aging, who has just arrived.
In Haiti three days of “memorializing the dead,” of prayer and fasting have begun.
Shortly after we arrived yesterday afternoon, Star and I crossed the street and walked down the ragged line of incongruously bright new tents that front the road. An open space gives us entry, and we wander through the maze of living and cooking spaces, a large, older white man, a small, younger black woman whose “bonsoirs” are often returned with smiles.
We reach one boundary of the encampment formed by a four-story concrete building which has been crushed like a paper hat. A young woman with an infant greets us. The baby is a little thin, a little dour, a little jumpy. Her name is Miranda, and she is two months old. Miranda’s mother shows me a place on her head where the nearby building had quite literally fallen on her. It hurts still, a month after the earthquake, and so do her neck and back. I go into her tent to take a look. There is great tension and tenderness at the site of her injuries. I do some gentle manipulation, and she smiles with relief. I reassure her that in time the symptoms will subside and remind myself to bring acupuncture needles next time.
Others have not been as fortunate as Miranda and her mother. One woman’s two children have been seriously injured and are still at the hospital. Another’s aunt has died. A third is missing her husband. A fourth has lost the sight in one eye. The pain from injuries received in the earthquake persist. Memories of loss and unspeakable terror seem to have attached to and continually restimulate the pain—the ever-present physical replaying of the catastrophe, the physical manifestation of psychological trauma and ongoing distress. Some “cannot remember the simplest thing,” or “make any decision.” The blind woman fears that she will not receive medicine without money to pay for it. No one sleeps well. All are fearful of further loss or injury, or—they are not quite sure what.
And, indeed, the situation is enormously stressful. The tents, which look so good, just arrived yesterday, brought by the French Red Cross. . For a month, these people have been sleeping in the open. “We have a committee,” says Wilson, Miranda’s father, “to organize ourselves.” And they are indeed cooking communally. “But we do not have toilets, or other necessary sanitation.” There are no doctors readily available to them, or medicine, or replacements for needed glasses lost, or hope for more adequate or permanent housing, or indeed, much communication with the world beyond the tent city. As we are leaving, Wilson invites us to share the rice that half a dozen families are beginning to eat.
More in days to come.
Day 1, part 1 of 2–Arrival
There is a weight to the air; we begin to feel it at the border where we enter from the Dominical Republic. We can smell it, too, in the swirl of dust that forces some to wear masks, in the acrid edge of burned and burning building materials. It grows heavier as we bump around flanks of rubble on the outskirts of Port-au-Prince. In the city, it roughens our voices and presses tears from our eyes.
Happily, surprisingly, we have a place to stay—in the Coconut Villa, a hotel near the airport that is an undisturbed island amidst collapsed houses. Across the street, several thousand Haitians live in tents.
Rosemary Murrain, Star Myrtil, and I are here to see if our approach can help bring psychological relief to the people of Haiti—and to see if we can work with and find support from the large international agencies that are funded to bring food, housing, schools, and emergency medical care to the people. Our approach, which combines such mind-body techniques as meditation, guided imagery, biofeedback, and yoga, self-expression in words, drawings, and movement, and small group support, has made sense to and worked remarkably well with war- and disaster-traumatized populations in Kosovo, Macedonia, Israel and Gaza, in post-Katrina New Orleans, and with US military returning from Iraq and Afghanistan. It’s practical, easy to learn, and feels right to people who are trying to gain control over the thoughts, feelings, and memories that overwhelm them in the wake of catastrophe. We’ve published the only randomized controlled trial (RCT) of any invention of any intervention for war-traumatized kids. It showed an 80% decrease in symptoms of posttraumatic stress disorder in Kosovo high school students, an improvement that was maintained at three months’ follow-up. More recent studies on 1,000 children and adults in Gaza show similar sustained gains in spite of the ongoing constraints and tragedy of life there. Altogether, the several thousand clinicians, teachers, and community leaders’ we’ve trained have made our CMBM model available to hundreds of thousands of children and adults around the world.
Rosemary is CMBM’s new Director of Finance and Administration. Immensely capable, unflappable, fluent in French, she’s an MBA student who has helped to create and lead educational programs throughout Africa. She’s in charge of the logistics that brought us on our journey here, and she will help create necessary partnerships. She’s also, I say with pride, my goddaughter. Star is her friend, a Haitian living in Florida, leading women’s programs there and fluent in Creole as well as French; a human bridge for us to Haiti and to its people.
I’ll post more this afternoon, about our visit to the tent city outside our hotel and the people we met there.
The Christian Science Monitor featured an article on our Healing the Wounds of War program in the Middle East! Ilene Prusher interviewed some of our Gaza trainees, and myself, to write this thoughtful piece. She also notes that it is the one-year anniversary of the Israel siege on Gaza, “Operation Cast Lead,” which devastated the people and landscape of Gaza, and from which they are still struggling to recover a year later.
Here is an excerpt of the article, but I hope you check out the original, with some pictures and related stories on Gaza and the Middle East, here.
Gaza war anniversary: How one group helps victims overcome trauma
By Ilene R. Prusher Staff writer / December 28, 2009
Rawya Hamam was watching her son deteriorate. Hisham wouldn’t sleep, clung to her incessantly, and said he wanted to go back into her belly so he’d be safe. “Grandma is lucky she died so she doesn’t have to live here now,” the boy told his mother.
It’s not a normal statement to expect from a five-year-old child, but neither were these normal times. A year ago, at the outbreak of war between the militant Palestinian group Hamas and Israel, anything resembling a normal life disappeared into a violent maelstrom that wreaked unprecedented destruction on the Gaza Strip. More than 1,400 Gazans were killed, according to a Palestinian count, in a campaign the Israeli army named “Operation Cast Lead,” with the aim of getting Hamas to stop the daily launch of occasionally fatal rockets onto Israeli communities. Thirteen Israelis were killed in the three-week war. . . . keep reading
We’re so thankful for the recognition of our work in Gaza, alleviating psychological pain and suffering, and all of the work we do, both in the Middle East and here in the US teaching health and mental health professionals to learning to handle their stress and incorporate mind-body techniques into their practice through our Mind-Body Medicine Training as well as our Healing Our Troops program. These warm, caring professionals we train use their skill and wisdom to help families recovering from disaster, like those who survived Hurricane Katrina, as well as working with troops returning from Iraq and Afghanistan and their families.
(If you kept reading my post, don’t forget to check out the rest of the original CSM article with pictures and related stories on Gaza and the Middle East, here.)