We returned from Haiti yesterday evening, where Kathy Walmer and her FHM colleague Missy had set up a remarkably varied and intensive visit for us and the students. Although our stay was less than five days, it feels as though a disproportionate amount of experience was fit into that span of time.

We conducted 46 trauma interviews in 3 communities: the rural Catholic community in Fondwa, an urban women's group in Leogane, and with members of a vodou-practicing rural community in Biloc, outside of Leogane.

FONDWA

In Fondwa, we did ten interviews with community members ranging from two sisters in the order of Saint-Antoine and their priest to various generations of a familial/village peasant ("peyizan") community. These interviews gave us our first test of the SPRINT-E Creole questionnaire, and an almost eerie narrative experience of the earthquake involving many of the same place names and characters, but always different foci of the drama, and different outcomes.Some of these interviews were conducted in the tents and cabins of the orphanage next to the ruins of the FHM guesthouse, and some in the families' little wooden houses or courtyards.

From the start, the phenomenon of Haitians' determined faith-based resilience was very evident, as was their healthy lifestyle, immersed in collective social life. We began each interview asking for the interviewee's general story of the earthquake, and often were struck by the disparity by the extremely traumatic stories recounted, and the narrative insistence within the survey process on relatively modest ongoing psychological impact. (This was most true of the priest, who had been in Port-au-Prince and talked about walking past trapped dying victims, and hundreds upon hundreds of bodies, every time he stepped out, and of living next to a school where 100 dead students were not removed for a month, but who insisted on having no traumatic psychological residue.)

The age of people interviewed ranged from 14 (--and we noted the need for a pediatric trauma questionnaire) to late 70s. We haven't yet done statistical analysis, but it seemed to us that the older middle-aged women were the hardest hit, expressing not only the trauma of injured family members or of prolonged periods of not knowing their destinies, but a very heavy burden of care; one woman said that she had become the "esklav" ("slave") of her husband and larger family, by which she seemed to mean simply that she was a constant care giver and domestic worker, with little freedom from the home--I meant to ask, but didn't get to it, whether she meant that she was like a "restavek" or domestic servant.

One older middle aged woman wept as she recounted the sudden extreme deterioration in the condition of her 75+ year old mother in law, who had always been selflessly energetic and devoted, after the earthquake. (The pretty elderly lady, in her nightie and support hose, sat and smiled sadly and nodded at the whole description.)

Several members of the community recounted the phenomenon of mountain hillsides falling in, or of the ground opening up, in some cases nearly swallowing up people. Without exception the Fondwa group was shocked to even hear a question about suicidality, emphasizing that they would never ever think of such a thing.

We asked about vodou, and people emphasized the conversion process that had followed the earthquake--for reasons that were not entirely clear to us. Many people attested that only "Bondye" could have been behind that magnitude of destruction, or their personal survival, and everyone described people yelling "Jezi!" ("Jesus") after the earthquake. Over time, we realized that these attitudes and verbal responses had also been true for many members of the voduizan community.

It was clear that people had no solid sense of what had caused the earthquake. When I spoke briefly with a 4 year old at the orphanage about what happened in earthquakes--after he asked whether many Americans had died in the earthquake in the US--word spread through the children immediately, and several others came up to pointedly ask me what I had said. There was clearly a crying need for Creole-language educational materials about the most basic science of earthquakes--and also of volcanos and tsunamis, since people expressed odd fears about these also.

LEOGANE

From Fondwa we went to Leogane, staying at the guesthouse of Manbo (vodou priestess) Jocelyn, who immediately talked about how much she missed Ben and Cindi! Her house had a backyard filled with trailers and tents of displaced people. We went to the FHM clinic where we met the Leogane women's group, maybe 40 or 50 women, and explained what we were doing.

We asked if they had heard about Duke University, and several of them whipped out their Duke fans, courtesy of Ben and Cindi! They talked about how very much they had enjoyed and benefitted from their time with Ben and Cindi and the relaxation techniques they had learned, and how important it was not to keep these things bottled inside them. They GREATLY valued their experience with Ben and Cindi. (See previous FHM story regarding Ben and Cindi’s Ally Program)

Once they were on board with doing more questionnaires, the leadership of the Women's Group set up a rigorous system through which women were sent every ten minutes to one of three groups--me in the delivery room, Jacques in a hallway, or the four students in another clinic room. We were able to interview 28. Most seemed, again, remarkably upbeat and confident, despite experiences ranging from the difficult to the unthinkable--one college student trapped under a dead classmate for over 24 hours, a mother trapped on top of her injured two year old. One of the Leogane women's group members suggested that we add a question about forgetting and other mental lapses to the trauma questionnaire.

That evening Manbo Jocelyn had arranged a drumming and dancing evening in her peristyle, and they did a gorgeous vévé and a memorable evening of singing and dancing, all involving generations of community members down to a 6 year old girl who danced through the entire ceremony. Some of the songs made reference to the earthquake and the divisions it had caused among Christian and voodou communities in Haiti.

The next morning we met with members of this vodou group, all from the little village of Biloc, and had a spirited conversation about the role of vodou in Haitian culture, vodou initiatives after the earthquake, and their perception of their scapegoating, and of the withholding of services and material aid from vodouizan communities.

We did interviews with five of the men afterwards, and one explained that in the first months after the earthquake they had founded a group called "Rasin Linyon" ("Roots Union"), where using a "Tèt ansanm" technique they had worked on helping people get over the "stress." They also explained that many of the vodou songs are updated with improvisational lyrics, and that a lot of this creative energy has been devoted to the subject of the earthquake. A young woman from a Ti Gwave voduizan community whom I interviewed also noted that in her area, the vodou leadership had planted reeds in the water source to prevent contamination after people in the camps had begun falling ill.

GERMAN NGO

That afternoon we visited a German NGO that does amputee and neurological rehabilitation, including psychosocial rehabilitation. There was a mobile prosthetics factory in the camp. The woman in charge of the psychosocial services, a wonderful young Canadian anthropologist named Serena, stressed their strong need for a mental health professional who could help the humanitarian aid mental health workers process their experiences. Serena noted the generally low levels of mental illness among the Haitian community.

BLANCHARD

From there we went on to the FHM clinic outside of Port-au-Prince, where we practiced giving the MINI French questionnaire to 3 French-speaking clinic employees.

NEXT STEPS

We now have a strong sense of small revisions that need to be made to our Creole translation of the SPRINT E--notably the use of a numerical scale rather than adjectives to qualify agreement with the answers, since the words were too hard to remember in verbal interviews, and a few other things. But mostly, the scale seemed to work well enough for use in a formal study. The MINI will also come in very handy after interviews that reveal serious issues, like suicidality, or possible mania.

It was an experience of Creole immersion like I have never had, and hearing people pour out their stories and life philosophies was unforgettable.