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Haiti: The work on mental well-being continues

Monday April 15, 2013
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The 7.0 magnitude earthquake that hit Haiti on Jan. 12, 2010, shook more than just the ground — it rattled the hearts and minds of the people in the Caribbean country. Surrounded by damage from the most powerful quake to hit the island nation in 200 years, many Haitians struggled to heal from physical injuries and find shelter, food and clean water. They also had to comprehend and deal with psychological trauma, such as post-traumatic stress disorder, that the earthquake left behind. Meanwhile, an existing maternal mortality problem raged on post-quake.

In response to Haiti’s mental health needs, the University of Miami School of Nursing and Health Studies World Health Organization Centre embarked on a one-year project aimed at educating Haitian healthcare professionals to identify and treat psychological trauma and other mental health issues. The project was funded by a one-year grant from the National Institute on Minority Health and Health Disparities.


Haitian healthcare professionals benefited from the guidance of University of Miami representatives, including, in the top row, Guerda Nicolas, PhD, professor, UM school of education and human development (far left); Carole Roseau Wilkinson, RN, school of nursing and health studies faculty member (second from left); and Rosina Cianelli, RN, associate professor in the school of nursing (third from left).
(Photo courtesy of the University of Miami)
The formal training program took place April 2011 through October 2011 in Cap-Haïtien, Haiti’s second largest city, and was held in conjunction with the local Ministry of Health, the city’s public school of nursing and L’Hopital Justinien. The program trained 113 healthcare workers, and thirteen participants were certified as new trainers so they could train others after the university’s team left.

Rosina Cianelli, RN, PhD, MPH, FAAN, associate professor at the school of nursing, said the university’s Miller School of Medicine already had ongoing medical projects in Haiti before the earthquake. But after the earthquake hit, new priorities emerged when the country’s need for mental health support became apparent, Cianelli said. Some residents fled from heavily damaged Port-au-Prince, which is 16 miles east of the earthquake’s epicenter in Leogane, to Cap-Haïtien, causing an increased need for support services to the north, Cianelli said.

The training program, conducted mostly in Creole, was specifically developed and taught for the Haitian culture by several Haitian-American professionals, including psychologists, psychiatrists, social workers and nurses, who kept cultural considerations in mind. "They know and understand the culture and what’s related with mental health issues, so that was a plus," Cianelli said.


Group of local healthcare workers planning a role-playing exercise during a training session.
For example, she said, supernatural powers and evil spirits often are related to mental health in Haiti, as Voodoo is interlaced in the religious culture of the country. A mental disorder is not recognized as an illness by some people, she said, but may be seen as a curse or evil influence. These issues were addressed in the training, as well as how to recognize symptoms of anxiety, depression and grief. Post-training, the team created focus groups to assess the program and its influence on the trainees. "What we found is that the training had an impact not only professionally, but also in their personal lives," Cianelli said.

A new initiative, not currently funded, will focus on maternal health. The WHO Centre is proposing a five-year project in the Southwest corridor of Haiti to help decrease maternal mortality in Haiti, Cianelli said, which was a big problem even before the earthquake. The proposal is to create a center to train nurses as nurse midwives to provide healthcare to mothers and children, Cianelli said.


Training session in Cap-Haïtien, Haiti.
The University of Miami School of Nursing and Health Studies was first designated a World Health Organization Collaborating Centre for Nursing Human Resources Development and Patient Safety in 2008, and this designation was renewed in 2012.

Maria Padron, project manager for University of Miami’s WHO Centre, said it follows the values of the nursing school. "We are very focused on patient safety, research, and curriculum and workforce development," she said.

The University of Miami center is one of only 11 U.S. nursing-related WHO Centres.


Andrea Scott is a copy editor. In December, Scott traveled to Haiti for a weeklong mission to assist healthcare workers in the area. Post a comment below or email editorSouth@nurse.com.