Leading American clinical psychologist, Dr. Judy Kurianksy, embarked on an "emotional first aid" mission to Port-au-Prince. Here is an excerpt from her seven day journey.
On Wednesday morning after the horrific earthquake in Haiti, it is 6 a.m. and I am asleep in my tent on the church grounds where Father Wismick and I are staying during this mission to his home land. We have come to try to retrieve the bodies of the ten young priests he has trained who are buried under the rubble of the school in which they were teaching. They were like his “sons.” Six nuns from his order are also missing. We fear the worst, that their bodies are under piles of rubble like innumerable others and will not be found. We have also come to assess the psychological needs of his cherished church community, and to see how else we can be helpful.
I am startled awake by some sensation that the earth is moving though I think I am dreaming. I later heard CNN’s Anderson Cooper say the same thing in his report. But I am alarmed at the commotion outside my tent. I unzip the tent and rush outside and a man tells me in French that there has been a big aftershock: 6.1. People are praying, led by the head priest Father Quesnel Alphonse. I suddenly notice a familiar site: a brown uniform I recognize from my childhood that my brother wore. It’s a Boy Scout. Memories of their motto, “Be Prepared” flood my mind. I did not expect to see Boy Scouts here, but why not? I know there is a worldwide Girl Scouts and Girl Guide organization because members were on my panel a few months ago about youth initiatives for peace, at the United Nations NGO conference on Disarmament in Mexico City.
A light goes off in my head: how perfect for the Boy Scouts to be here. They would be ideal for the role of “comforters” for the suffering children at the church here and for the patients at the hospital at which we have been headquartered. The President of Hopital de la Communaute Haitienne (HCH), Georges-Michel Celcis, had welcomed us as family, saying “Vous êtes de la famille,” so how perfect for the Boy Scouts to be part of that family. Apparently, the scouts have been assigned to this church to help out with practical tasks like food distribution, but why can’t they also be taught the simple comforting skills that I have used to train other community leaders in disasters, like basketball coaches and school teachers. These comforters as I call them, need primarily to have a “heart” and be “caring.” The Boy Scouts fit that bill, with their training for community service. My brother was a Scout and he was caring; and I was a Girl Scout for years, so I know well the spirit of scouting.
Father Wismick appears from the church grounds where he was staying - literally across (what is left of) the street - where he has been sleeping on the ground in open air in the sleeping bag we brought along. Dozens of other people spend the night in open air to avoid being trapped under collapsing buildings in the case of aftershocks.
I describe my plan to enlist the Boy Scouts, and he loves it. So we describe it to the Scouts gathered in the churchyard.
They all are enthused to take on this new role to help others I can sense that they all would be wonderful, from my intuition about people’s personalities honed from years of being on the radio and knowing in an instant from a person’s voice whether they are warm and caring.
I get to work right away, guiding the young men to a somewhat quiet corner of the church grounds. They only speak French (no English) so I am grateful for all the years I spent studying the language and even reading Descartes and Camus in French when I thought I might major in French in college (thanks to my mom) and spent an intensive summer studying in Geneva. My accent is rusty and some vocabulary fails me, resorting to English words like “breathe” until I remember “respirer.” Since Father Wismick is impressed with my French, I feel reassured. Of course, Creole is another matter.
There are two tasks ahead of me. Task 1 is to teach the scouts simple ways to cope with their own stress, as I know they have also lost loved ones and have been traumatized. Task 2 is to teach them simple techniques they can use with children and patients. I delve mentally into my “toolbox” of techniques that I have developed over the years working in trauma situations, that I catalogued in a paper I wrote for a professional book aimed at teaching graduate students, to pick techniques I think would work in this culture in this situation.
The Scouts are eager. They are Deneu, Sincy, Marcelin, Jhonny, Jean Bathiste and Antoine.
I tell them that my goal is for them to feel strong “dans le corps and le coeur” (in the body and the heart). The first step is to achieve Calmness, using the breathing technique of exhaling to one more count than inhaling. Using this breathing, the next step is “Grounding,” to feel secure within themselves, by squiggling their feet into the ground to feel rooted into the earth for a sense of solidity “comme un arbre” (like a tree).
Another one of the techniques – one of my favorites – is aimed at feeling safe, since achieving a sense of safety is absolutely fundamental in any crisis. This technique has been very effective in many cultures after disaster. In this 3-part Security Exercise, they start out holding their hand on their heart saying “Je suis en securite” (“I am safe”); then turn to a partner reaching out their hand saying “Vous êtes en sécurité” (you are safe), and then make a circle extending to all the others “Nous sommes en sécurité” (we are safe).
I also teach them techniques to help ameliorate headaches and stomaches. Somaticizing emotional distress by having a physical symptom is very common for people, and especially children, particularly in non-western cultures where people do not traditionally talk about feelings.
Every intervention has to be sustainable. So, I tell them that whatever they have learned, they can pass on to others, who can teach others. In emergencies, things have to be done immediately, so I ask them to find any children who may be suffering, and let’s put the techniques into practice right away, under my supervision, until they can do it on their own. Jean Bathiste brings over a young child, and asks in Creole if he has any pains. He motions he has head aches.
I watch admiringly as the scout repeats the steps I did with him, instructing the young boy to imagine taking the head aches out of his head, and finding a remote hole in the ground and burying it in the hole. The boy does it willingly and tells JB that he feels better. It’s a start. I tell JB I am proud of him; everyone needs reinforcement.
Another important part of psychological first aide in trauma situations is acknowledging the helpers, who themselves are suffering losses or certainly stress. Wismick has told me that such appreciation is even more helpful in Haiti as people are not used to being told nice things about themselves (parents don’t tell children that they are wonderful; even if they say so to others). He thinks it would be wonderful if parents complimented children verbally. I reflect about how my mother was always so encouraging and openly admiring of her children, constantly telling my brother, sister and me how smart and capable we are, bolstering our self-confidence. I note this is an important aspect of psychological care for this culture.
The scouts come with us to the hospital. We start a meeting with staff about future plans, but one of the staff interrupts, saying that they cannot talk about the future, since there was a 6.1 aftershock this morning and they have to get busy. She impatiently asks, “We are in a crisis, what can you do now?” Of course, she is right; this is an emergency; time for action, not talk. The scout motto flashes across my mind, “Be Prepared.” We roll up our sleeves and go out to offer support.
We gather bottles of water to hand out to patients. The Scouts are enthused about their new role, despite some having normal shyness when thrown into such a new role. But they are so courageous and kind-hearted. I watch as they approach the patients lined on blankets under sheets or tent coverings, and talk with them in Creole. I can see that they are doing exactly what they need to do: offer essential life-sustaining water and provide a caring presence.
At the end of the day, we gather for debriefing, and the Scouts are all enthused and excited about what they accomplished.
Father Wismick and I are thrilled.
The next day brings more volunteers thanks to the hospital social worker, Jean Yves Valcourt, a social worker who runs the AIDS clinic. He sends out an email to students, that goes to a wide network of interested youth who want to help.
That next morning, we meet the Scouts at the church grounds for another day at the hospital. Father Wismick corrals a flatbed truck so the scouts can pile into the back and we get in the cab. Such things like transportation in such a crisis have to be done sometimes “catch as catch can.” You can prepare as much as you can for an experience like this, but then you have to improvise and go with the flow “on the ground” given the situation. When you see a possibility, you have to act on it immediately, as in the case of finding the right vehicle to cart all of us the few miles to the hospital.
We are delighted when we arrive at the hospital to find that Jean Yves’s network has resulted in 30 students showing up, ready and willing to be trained to be comforters. The Boy Scouts have already had a day’s previous training. We set to work.