Protecting children and preserving mental health in the wake of disaster in Haiti
On Tuesday, January 12, 2010, an earthquake measuring 7.0 on the Richter scale killed or gravely injured thousands of people in the vicinity of Port-au-Prince, Haiti. According to the United Nations (UN) Office for the Coordination of Humanitarian Affairs, 30 percent of the 200,000 people who lost their lives were infants and children, and over 300,000 people suffered physical injury. Most of the 250,000 collapsed buildings were residential, rendering one million families homeless overnight. Hospitals and schools collapsed; governmental and commercial buildings were destroyed. The devastation was incomprehensible.
The extent of psychological damage from the January 2010 earthquake remains unclear in a country where the mental health infrastructure was rudimentary even before this disaster devastated this impoverished nation. Some of the most harrowing stories of the destruction are those of children – alone and severely injured. Children represent one-half of Haiti's 10 million population; and aid agencies estimate that 1 million Haitian children are at high risk of ongoing physical and psychological trauma secondary to the disaster. In coordination with the Haitian government, several humanitarian organizations have mobilized to protect the safety and welfare of the country’s children....
Eligible applicants include residents, trainees in post-residency clinical fellowships or other health-related post-doctoral programs, &/or those within 3 years of last major degree training (e.g. registrar, residency, fellowship, doctoral program).
This time, it's 3-questions-for Vikram Patel, Professor of International Mental Health & Wellcome Trust Senior Clinical Research Fellow in Tropical Medicine at the London School of Hygiene & Tropical Medicine and Sangath in Goa, India. While we spoke specifically about the training of psychiatrists, this advice is valid for anyone trained as a mental health specialist provider.
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Kleinman's "Secret History" Insists on Action by Pamela Collins
Professor Arthur Kleinman, anthropologist and psychiatrist, delivered a provocative message in his presentation, "The Secret History of Global Mental Health," at the April 2009 gathering of the New York International Mental Health Interest Group.
"No group of patients in the world is as stigmatized and bereft as the untreated mentally ill," Kleinman said, with quiet emphasis. He chastized the field of psychiatry for its lack of action on behalf of people with mental illness in low- and middle-income countries. Among the obstacles to action, he listed the "absence of a sufficient number of professionals who actually commit their careers to global mental health or can find the resources to commit their careers to global mental health" and the absence of funding to support research and training needs.
Kleinman encouraged the "robust evaluation of demonstration projects" and bemoaned the lack of commitment to scaling up existing demonstration projects. He alluded to the work of Jim Kim, Paul Farmer and others, whose actions on behalf of people with AIDS in poor countries contributed to the introduction and scaling up of AIDS treatment in sub-Saharan Africa and other settings.
Despite the difficulties of pursuing a global mental health career, Kleinman called for "antiheroic" action. He explained that these were "people who are willing to step out of the ordinary and do the non-conventional, recognizing that there's a small chance they'll have a game changing effect." Kleinman noted that these people provide something else, "they become a moral exemplar, taking the road less traveled." He reminded the social workers, psychology interns, psychiatric residents, anthropologists and psychiatrists that the field needed people "who recognized that their contribution would be small, that their involvement does not yet capture the spirit of the times." He warned that career advancement was not the reason to pursue this field; rather, a moral commentment to change the world.
