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Prince. No other psychiatrists offer services in Northern Haiti. Mental health services have, unsurprisingly, received little funding by the government.

Given this longstanding lack of formal health care resources, Haitians have learned to deal with their mental health problems through deployment of various strategies common to resource-poor regions. As explained previously, a very large number of Haitians make use of traditional practitioners or religious healers when face with mental health problems. There are several types of traditional healers available in Haiti who may treat specific illnesses or address general well-being:

  • doktè fèy, medsen fèy (leaf doctor) or herbalists often treat illnesses such as colds,

worms, diarrhea, and stomach ache;

  • oungan (Vodou priest) or manbo (Vodou priestess) treat many conditions;

  • doktè zo (bone setters) treat conditions such as broken bones, musculoskeletal or

joint discomfort;

  • pikirist (injectionists) administer parenteral preparations of herbal or Western

medicine) (Miller, 2000)

  • fanm saj (midwives) perinatal and natal care.

In recent years, Haitians have mobilized a network of community resources to sensitize the population to social issues related to various problems such as violence against women and children’s rights. These grassroots organizations also serve as self-help and support groups for people facing severe life events and ongoing stress. Self-help illness support groups have also emerged, but characteristically, these tend to focus not on the illness but on religion and spirituality, artistic and expressive activities and ways of generating income to better support participants and their families.

Birth. In rural areas midwives (called matwòn or fanm saj) deliver babies and perform most prenatal and postpartum care for both mother and child. Immunizations are not easily available to rural residents. Mother and child spend the first month or 40 days in seclusion, during which time the circle of women close to her provide for her needs. This period of seclusion stems from a common belief that maternal illness can be caused by rapid and excessive chilling of the body. If the mother becomes chilled, it is believed that the disequilibrium may be passed on to the baby through the nursing milk and may cause tetanus and diarrhea. The mother must also avoid move san (‘bad blood’, distress caused by a fright or exposure to negative emotions) as this can cause lèt gate (‘spoiled milk’) as well as diarrhea, skin rashes and failure to thrive in the infant. Breast milk can become too thick and can give the mother headache and cause depression in the mother and impetigo in the infant. Farmer describes move san as “illness caused by malignant

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