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Disorders Related to Trauma and Loss

The Haitian earthquake exposed massive segments of the Haitian population to trauma and loss. Many people lost loved ones, houses, businesses and their livelihoods. Many witnessed death and serious injury during and after the earthquake. This has been compounded by civil violence following the earthquake. These severely traumatic events will likely have an impact on the mental health of many Haitians. This may especially be the case for those with pre-existing vulnerabilities or prior exposures to trauma.

Haitian women have been recognized as more likely to develop disorders related to trauma because of their vulnerability to various types of violence, including conjugal violence, civil violence and political disorder. A study by Roseline Benjamin, a psychologist working in Port-au-Prince with victims of conjugal violence found that among 1505 women residing in 9 territorial departments “70% had been victims of violence, of which 37% was sexual violence, 33% physical violence; the offender is most often known by the victim (65%) or is the partner (36%). Many women subsequently develop symptoms of posttraumatic stress disorder (PTSD), depression, anxiety and somatic problems” (Jaimes, Lecomte & Raphael, 2008).

Another Haitian psychologist, Norah Desroches Salnave, who saw many young patients from various milieus each week in Port-au-Prince found that about 40% had problems that may be related to violence, kidnappings, death of family members, rape and gang related violence (Jaimes, Lecomte & Raphael, 2008). The climate of terror in certain parts of the country creates chronic insecurity, aggravated by the violence experienced by children in school or at home. The effects of violence on the psychological development of children may be serious, including: delays in development, social difficulties, affective disorders, behavioral problems, or educational difficulties.

The effects of trauma are seen not only in local variants of disorders of anxiety, depression and PTSD. In writing about violence and trauma in the context of the 1991- 1994 coup and the years that followed it, James found that “the most common laments among viktim [victims] were feelings of shame, humiliation, powerlessness, and isolation or disconnection from their families and communities” (2004, p. 137). Both men and women lamented their inability to live up to their social roles as providers for their children, and men in particular expressed rage over loss of status and property. Men’s shame over their inability to act as providers often led to the abandonment of conjugal partners and children, leading to increased vulnerability for the latter.

Aid workers may have expectations for the structure of trauma stories that do not fit with local styles of narration. James (2004) describes the structure of trauma victims’ narratives in Haiti, which may not follow a linear sequence, and also addresses the

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